Your nose is the most prominent feature on your face, the central point of focus on which the balance of your eyes, mouth, and other facial features rest. Ideally, your nose should be in such harmony with your other features that it doesn’t detract attention from your eyes and lips. It should have such a natural fit with your appearance that it plays a background role, allowing the attractions of your eyes and mouth to stand out.
A wide nose can upset this visual balance. If you have a wide nose and are dissatisfied with its appearance, rhinoplasty, or nose surgery, can change its shape, bringing it into better proportion with your other facial features. When performed by a skilled cosmetic surgeon, rhinoplasty for a wide nose can subtly enhance your appearance, giving you a natural-looking beauty and the face you wish you had been born with.
Rhinoplasty for a wide nose can also improve your breathing. The anatomy of a low, flat, and wide nose often brings breathing problems such as sleep apnea and snoring.
If you are considering rhinoplasty for a wide nose, here are some key things to be aware of to get the best results.
What Part of Your Nose Is Wide?
Noses come in all shapes and sizes, and there is no single characteristic that makes a nose look wide. Your nose may have wide nasal passages and nostrils. It may have a flat shape and not project far from your face. You may think the tip of your nose is too broad or too bulbous. The bridge of your nose — the upper portion where it joins the brow between the eyes — may be overly broad in the context of your other features. Or, you may have a very low bridge that causes your nose to look wider. Each of these features is a unique aspect of your nose. And you need to consider them all when thinking about an improved nose form.
The perfect rhinoplasty solution will correct the issues that make you self-conscious about your appearance. It will do so with a sensitivity to your overall features while creating a new and natural-looking harmony in your face. It will also build on the natural underlying structure of your nose without attempting to make too dramatic a change. Overly aggressive rhinoplasty — surgery that tries to give you someone else’s nose, rather than a refinement of yours — can have unfortunate results.
You should also consider the ethnic aspects of nose appearance. People of African heritage tend to have wider noses than do people of Asian, Middle Eastern, or Caucasian heritage. The best rhinoplasty surgeons respect the ethnic heritage of their patients. They work to sculpt a nose to bring it into harmony with the other facial features, rather than trying to impose a single standard of beauty.
Surgically Correcting a Wide Nose
The techniques used to correct a wide nose will depend on your nose’s shape and underlying structure, as well as your goals for the change.
The nasal bones, which form a pyramid structure below the skin, determine the overall shape of your nose. Most rhinoplasty doctors break these bones very precisely into smaller pieces, which they can move to reshape the form of the nose from below. Narrowing a wide nose requires trimming the bones and pulling them closer together to make a thinner structure. This bone reshaping is called an osteotomy.
Dr. Singer uses two main approaches. In a medial osteotomy, the focus is on changing the form of the middle ridge and top of the nose. A lateral osteotomy requires reshaping the longer, outer sections of the nasal bone. Many rhinoplasties for wide noses use both approaches.
If you want to narrow the base of your nose and the spread of your nostrils, Dr. Singer may combine osteotomy with other techniques that remove narrow wedges of tissue from the bottom of your nostrils and pull the remaining tissue together into a thinner shape.
If your nose appears wider because the bridge is low, he can raise the height of the bridge by adding tissue. This technique might require harvesting cartilage, bone, or the connective tissue called fascia from elsewhere on your body and grafting it to the area. Or, Dr. Singer can accomplish it by inserting layers of synthetic material. Tissue grafts can also extend the length of the nose and give it more definition.
Dr. Singer can narrow a bulbous or flat, wide nasal tip by precise thinning and reshaping of the soft tissue and cartilage at the end of the nose. Grafted cartilage may also help give the end of the nose more definition.
“Open” vs. “Closed” Surgery
Dr. Singer almost always performs rhinoplasty on an outpatient basis using a local anesthetic. He uses two different surgical approaches.
- In an “open” rhinoplasty, Dr. Singer makes a small incision below the tip of the nose, across the narrow strip of skin that separates the nostrils. This opening gives him full access to the interior structures of the nose for modification and reshaping. Dr. Singer uses this open rhinoplasty approach in most procedures to thin a wide nose, because this surgery typically requires extensive reshaping. This approach leaves a small scar on the underside of the nose. In the hands of a skilled surgeon, this scar will be virtually invisible, hidden in the natural contours of the nose.
- In a “closed” rhinoplasty, the incision is inside the nostrils, leaving no scarring on the external skin. Dr. Singer frequently relies on this method in cases where he is making less extensive changes to the nose, as it allows more restricted access.
The choice of open or closed rhinoplasty is ultimately up to Dr. Singer and will depend on the nature of the changes being made and his confidence in each approach for accomplishing the goals for the procedure. But it’s worth understanding the difference between them as you make plans for your rhinoplasty surgery.
What to Expect in an Improved Nose
In the hands of an excellent surgeon, rhinoplasty can transform your appearance, but the architecture of your nasal anatomy will limit the changes Dr. Singer can make to your nose. He can add cartilage and other tissue to raise a low bridge or give more definition to the tip of your nose, and narrow the parts of your nose that are overly wide. But you will end up with an improved version of your nose, not a copy of someone else’s. The most satisfied rhinoplasty patients are those who have the procedure seeking improvement, not perfection.
If you have a particular nose shape in mind for your rhinoplasty, it’s OK to describe that to Dr. Singer and to bring pictures to your consultation. But it’s essential to be realistic in your expectations. Dr. Singer will perform your rhinoplasty with the materials available — your nose as it is now — and will plan it in such a way that it brings improved harmony to your facial features, rather than introducing a new and unnatural look. A nose that looks perfect on someone else may not look right for you.
The goal for your rhinoplasty should be a natural-looking nose that works well on your face. Done well, your rhinoplasty will refresh your appearance and make you look more beautiful or handsome in subtle ways. People should notice that you look better, but not be able to say exactly why. Your new nose should blend in with your face, not stand out.
Choose Your Plastic Surgeon Carefully
Rhinoplasty is among the most difficult of all plastic surgeries to perform. Excellent results require skill, training, experience, a deep awareness of the underlying structures and functions of the nose, and an appreciation for the diversity of beauty in the human face.
Tiny alterations to the nose’s underlying bone and cartilage structure can result in significantly different results. Poor surgical technique or an overly aggressive approach can lead to disastrous outcomes with permanent deformity. And it’s not just your appearance that’s at stake. It’s also your ability to breathe freely and easily. So it’s vital to choose your surgeon wisely.
For any plastic surgery procedure, you should look for a board-certified plastic surgeon (a surgeon who has met the requirements of the American Board of Plastic Surgery). When considering nose surgery, you should screen candidates even more thoroughly to find a surgeon who has extensive experience in performing rhinoplasties. A surgeon who is an expert at other rejuvenation or body-sculpting procedures may not have the skill to do superior work on your nose.
Start by looking at the surgeon’s website for evidence of expertise in rhinoplasty. Read the doctor’s explanation of their approach to rhinoplasty and what the site says about their experience with the procedure. If a before-and-after photo gallery is available, look at those pictures carefully. If all the altered noses look similar, that’s a warning sign that the doctor has a fixed idea of what a beautiful nose should look like. If the “after” noses show a variety of shapes and sizes and each looks to be in harmony with the patient’s unique facial features, that’s a good sign that the doctor works closely with each patient to deliver appropriately customized results.
Look for examples of wide noses like yours in the gallery. If you see some, and the results look pleasing to you, that’s a plus. If you don’t see wide noses in the gallery, make a note to ask to see more pictures when you schedule a consultation. Most websites have limited space for posting photos, but the doctor should be able to show you many more.
What to Expect During Your Rhinoplasty Consultation
Once you’ve narrowed your search to a promising candidate, schedule a consultation. This meeting is your chance to interact with the doctor, ask questions, and see more before-and-after pictures that relate closely to your face. Take note of how much attention the surgeon pays to you — your unique features and wishes for a new look. A good consultation should be a two-way conversation and should include an examination of your nose.
After studying your facial features and nasal structure and listening to your hopes for the procedure, a good rhinoplasty surgeon will explain what they can do in your particular case — not just talk in general about the procedure. Don’t be put off if the surgeon pushes back on your ideal goal for your appearance. That could be a good sign that the surgeon is unwilling to risk an inappropriate change that could have disappointing results. You should come away feeling that your surgeon has listened to you, that they appreciate what is special about your facial features, and that they have a plan for changing your nose to enhance the beauty and harmony of your face.
Many surgeons can use computer simulation during their consultation to show you a close approximation of what your nose will look like after various surgical changes. This rendering can be a helpful tool for clarifying the look you want from the procedure, and for adjusting your expectations based on the surgeon’s knowledge of what is safe and reasonable, given your nasal anatomy. The imaging can help you and the surgeon have a good two-way conversation and arrive at an optimal plan for the procedure.
Dr. Robert Singer, in La Jolla and San Diego, is a board-certified plastic surgeon skilled in creating beautiful and natural-looking results. He is an extremely experienced rhinoplasty surgeon, having performed around 2,000 rhinoplasties in his practice. Call us at (858) 455-0290 or contact us today to schedule a consultation with Dr. Singer.